Clinical Utilization Nurse Specialist

3 days ago


Averill Park, New York, United States Albany Medical Center Full time
Job Summary

We are seeking a skilled Clinical Utilization Nurse to join our team at Albany Medical Center. As a key member of our Care Management department, you will play a critical role in ensuring the highest quality patient care and outcomes.

Responsibilities
  • Conduct thorough utilization reviews to ensure medical necessity and appropriateness of patient admissions and continued stays.
  • Collaborate with the healthcare team to identify areas for clinical documentation improvement and implement strategies for improvement.
  • Monitor length of stay and ancillary resource use to achieve continuous quality improvement.
  • Communicate with patients, families, and healthcare providers to ensure seamless care transitions.
  • Identify potential quality issues and report to the Quality Department for further review and action.
Requirements
  • Current New York State RN license.
  • Bachelor's degree in Nursing or related field preferred.
  • Minimum of three years clinical experience, with recent experience in case management, utilization management, or discharge planning in an acute care hospital preferred.

Albany Medical Center is an equal opportunity employer and is committed to ensuring a safe and inclusive work environment. This role may require access to sensitive information, and workforce members are expected to ensure information protection.



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